| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,061 |
5,699 |
$279K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
193 |
154 |
$228K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,467 |
2,041 |
$178K |
| 76830 |
Ultrasound, transvaginal |
2,515 |
2,123 |
$169K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
1,039 |
849 |
$56K |
| 81025 |
|
6,521 |
5,398 |
$34K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,533 |
1,174 |
$31K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,679 |
1,513 |
$30K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,600 |
1,449 |
$26K |
| 76801 |
|
298 |
262 |
$21K |
| 81000 |
|
4,935 |
4,190 |
$16K |
| 87210 |
|
4,483 |
3,733 |
$15K |
| 81002 |
|
4,568 |
3,672 |
$12K |
| 85018 |
|
4,649 |
3,827 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166 |
145 |
$9K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
162 |
117 |
$9K |
| 99385 |
|
94 |
80 |
$8K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
42 |
41 |
$4K |
| 0503F |
|
318 |
268 |
$760.66 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
14 |
$321.13 |
| 59430 |
|
18 |
13 |
$240.00 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
17 |
13 |
$56.98 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
69 |
64 |
$38.93 |
| 0500F |
|
40 |
38 |
$0.00 |
| 0501F |
|
213 |
193 |
$0.00 |
| 0502F |
|
1,549 |
1,237 |
$0.00 |